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NPI Code Detail

MEDICARE: SUZANNE MOORE NP

MEDICARE: SUZANNE MOORE NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerNP6072CA

General Provider Information

NPI Number : 1730253410
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE MOORE NP
Provider Business Mailing Address
First Line : 2710 MIDDLEFIELD RD
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-3404
Country : US
Telephone Number : 650-364-6010
Fax Number :
Provider Business Practice Location Address
First Line : 2710 MIDDLEFIELD RD
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-3404
Country : US
Telephone Number : 650-364-6010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 07/08/2007

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